Abstract 16392: Arrhythmias in Acute Care Cardiology: Prevalence, Therapies, and Outcomes- An Analysis of the Pediatric Acute Care Cardiology Collaborative (PAC ³ ) Database

Introduction: Arrhythmias are common in pediatric cardiology patients, yet prevalence during hospitalizations and treatments are poorly defined. This descriptive study reports arrhythmia prevalence and medical management from Pediatric Acute Care Cardiology Collaborative (PAC ³ ) centers.

Aims Our primary aim is to describe prevalence and outcomes of treated arrhythmias among acute care cardiology units (ACCU). Secondary aims include comparison of medical vs. post-operative admissions and selection of antiarrhythmics.

Methods: We performed a multi-center retrospective review of the PAC ³ registry limited to hospitalized patients with an arrhythmia treated from 2/2019-2/2023 among 33 centers. Arrhythmias are classified in the registry as Atrial Tachycardia/Supraventricular Tachycardia (AT/SVT), Junctional Tachycardia (JT), or Ventricular Tachycardia (VT). Descriptive statistics, Wilcoxon-Mann-Whitney, and χ2 testing were used.

Results: Prevalence of treated arrhythmia in the cohort (n=38,396) was 5.4% (n=2,090 patients) over 2291 hospitalizations. AT /SVT (68.3%) were more frequent than VT (21.5%) or JT (2.8%) (p<0.01). Bradyarrhythmias (7.5%) were infrequent. Of 8,733 CICU transfers, 513 (5.9 %) transfers of 257 patients (2.0 transfers/patient) were due to arrhythmia. Medical and Surgical patients varied in demographics and outcomes (Table). For AT/SVT, propranolol was the most prescribed antiarrhythmic, followed by sotalol. (Figure).

Conclusions: Treated arrhythmias are prevalent in ACCU patients and are a relatively frequent cause of ICU transfers. Arrhythmia treatment patterns warrant further investigation and could be the subject of QI.